Provider Demographics
NPI:1376553842
Name:KANTOR, LEON THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:THOMAS
Last Name:KANTOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4501
Mailing Address - Country:US
Mailing Address - Phone:716-648-1880
Mailing Address - Fax:716-648-1880
Practice Address - Street 1:11 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4501
Practice Address - Country:US
Practice Address - Phone:716-648-1880
Practice Address - Fax:716-648-1880
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist